mental status exam

what components are being looked at in a mental status examination

orientation and alertness, appearance, speech, mood and affect, incongruence

orientation and alertness

person- ask them who they are and what their name is. place- do they know where they are. time- ask them the date, day of the week,the year,

mood

subjective; refers to the patient's self reported persistent emotional state or feeling over a period of time

affect

objective; observable emotional expression during interview

flat/blunted affect

no, or very minimal emotional expression; the patient appears emotionally "flat" with little to no facial expression, gestures, or vocal variation (often seen in depression, schizophrenia, or neurological conditons)

labile affect

rapidly shifting or exaggerated emotional expressions; patients affect quickly changes from one emotion to another (bpd, bipolar disorder, or during episodes of mania or emotional instability)

constricted affect

reduced emotional expression that is less severe than flat affect; limited range of emotional expression (depression, anxiety)

normal affect

appropriate and consistent emotional expression that matches the context; the patients affect is suitable for the situation

congruence

when mood and affect are consistent with each other

incongruence

mismatch between mood and affect; patient might appear tearful but report feeling fine

emotional blunting

significant reduction or absence of emotional expression and feeling

thought process

how the thoughts are developing, how the thoughts are related to each other, are they appropriate answers, do they make sense

loosness of association

A thought disturbance demonstrated by speech that is disconnected and fragmented, with the individual jumping from one idea to another unrelated

tangential thinking

wandering off the topic and never providing the information requested

circumstantial thinking

a client eventually answers a question but only after giving excessive unnecessary detail

flight of ideas

rapidly changing or disjointed thoughts (jumping between topics, rapid speech, easily distractable, pressured speech)

pressured speech

speech may be difficult to interrupt, and the individual feels a compelling need to keep talking

ideas of reference

The feeling that causal incidents and external events have a particular and unusual meaning that is specific to the person.

thought content

what the patient is actually talking about; looking at what the client is saying vs. how they are saying it

delusions

significant disturbances in thought content; false, fixed beliefs that are not based in reality and are firmly held despite evidence to the contrary

types of delusions

persecutory delusions, thought broadcasting, thought insertion, mind control, mind reading, grandiose delusions, delusions of reference, somatic delusions

persecutory delusions

belief that one is being harmed, persecuted, or plotted against

thought broadcasting

one's thoughts are being broadcast out loud so that they can be perceieved by others

thought insertion

one thought's are not their own but they are inserted into one's mind from external sources

mind control

belief that something from outside the person, an external force, is controlling their thoughts, feelings, impulses, and actions

mind reading

one believes that others have the ability to read one's mind

grandiose delusions

belief that one has special powers, talents, or is of great importance

delusions of reference

a person believes that unrelated events, objects, or statements are specifically directed at them or hold special personal significance

somatic delusions

persistent and irrational conviction that there is something wrong with one's body, despite a lack of medical or physical evidence

hallucinations

perceptions that occur in the absence of any external stimulus; meaning the person perceieves something that is not actually present in reality; sensory experiences that can affect any of the five senses

types of hallucinations

auditory, visual, tactile, olfactory, gusatory

auditory hallucinations

hearing sounds, voices, or noises that others do not hear

visual hallucinations

Seeing objects, people, or things that do not actually exist

tactile hallucinations

feeling bodily sensations

olfactory hallucinations

smelling odors that are not really present

Gusatory Hallucinations

tasting things without a stimulus